Original InvestigationsOutcome of IgA nephropathy in adults graded by chronic histological lesions
Section snippets
Patient selection and clinical parameters
The files of all adult patients with a renal biopsy diagnosis of IgA nephropathy in our institution between 1985 and 1991 were reviewed. The selection criteria included: (1) a diagnosis of IgA nephropathy based on predominant mesangial IgA-containing immune complexes detected by immunofluorescence study in ultrastructures, irrespective of light microscopic features, excluding patients with such systemic diseases as diabetes and systemic lupus erythematosus, chronic liver diseases, renal
Results
Of 126 adult patients, 74 were women and 52 were men, with a 1.4 woman-man ratio confirming the female preponderance of IgA nephropathy in our region.3, 6 Age ranged from 18 to 62 years, with a mean age of 32 years. Follow-up ranged from 8 to 14 years, with a median of 10 years. Among these 126 patients, 25 patients (20%) reached end-stage renal failure over a 10-year median follow-up. By univariate analysis using the Breslow test, the histological parameters of GG, TIG, and HA and degree of
Discussion
IgA nephropathy is the most common glomerulonephritis worldwide, currently with no specific effective therapy, and up to 30% of the patients progress to end-stage renal disease.2, 4, 5, 6 For such a chronic nephropathy, and for many patients a slowly progressive disease, it is thus imperative to identify factors permitting not only prediction of renal outcome, but also the detection of high-risk patients, which is important in planning the long-term management of these patients.
Although a
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Cited by (72)
Endothelial cell injury in acute and chronic glomerular lesions in patients with IgA nephropathy
2016, Human PathologyCitation Excerpt :Renal insufficiency and proteinuria are known to be strong risk factors in terms of the prognosis of IgAN [20–23]. Chronic glomerular lesions, particularly those with glomerular sclerosis and fibrous crescent formation, have also been emphasized to be valuable prognostic lesions of ESRD in cases of IgAN [22–28]. In the present study, the loss of CD34+ glomerular capillaries was accompanied by segmental and global glomerular sclerosis with or without fibrous crescents.
Treatment of early immunoglobulin A nephropathy by angiotensin-converting enzyme inhibitor
2013, American Journal of MedicineLong-term study of mycophenolate mofetil treatment in IgA nephropathy
2010, Kidney InternationalThe Oxford classification of IgA nephropathy: Pathology definitions, correlations, and reproducibility
2009, Kidney International
Address reprint requests to Fernand Mac-Moune Lai, FRCPA, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Room 34055, Shatin, Hong Kong, China SAR. E-mail: [email protected]